Healthy close relationships are a key predictor of well-being, but a growing number of Americans don’t have supportive social connections. This includes older adults. Nearly 25% of people 65 and older are considered isolated, and many report feelings of loneliness.
As an aging adult, you’re more likely to face changes and challenges that disconnect you from your community. This puts you at greater risk of serious health issues linked to social isolation and loneliness. But there are steps you can take to help yourself or your loved one stay connected. Here’s what you need to know.
What Are Social Isolation and Loneliness?
Although some people use “social isolation” and “loneliness” interchangeably, they are not the same thing. While both are strongly linked to negative health effects and often overlap, here are some key differences:
Social isolation refers to a lack of social contact. It’s an objective measure, meaning it can be observed by others. For example, someone who is isolated may live alone, rarely interact with people outside their home, or stop doing social activities. People who are isolated may or may not be lonely.
Loneliness is subjective. It’s a distressing or negative feeling you have about the quality of your relationships. There’s a gap between the meaningful connections you want and the ones you have, regardless of how many people you see or talk to on a regular basis.
Health Effects of Social Isolation and Loneliness
The U.S. surgeon general considers social isolation and loneliness a public health crisis, and for good reason. Decades of research show that both are linked to negative health outcomes comparable to:
- Smoking
- High blood pressure
- Obesity
- Lack of exercise
Studies show that older people without strong social connections have a greater chance of early death for any reason, along with a:
- 50% increased risk of dementia
- 29% increased risk of heart disease
- 32% increased risk of stroke
Social isolation and loneliness are also linked to higher rates of:
- Obesity
- A decline in thinking skills
- Alzheimer’s disease and other forms of dementia
- Weakened immune system
- Inflammation
- Type 2 diabetes
- Migraine
- Poor sleep
- Hospitalization and ER visits, particularly for people with heart failure or heart attacks
There’s growing evidence that loneliness may be uniquely damaging. More research is needed to confirm, but people who report feeling lonely are more likely to have mental health complications like:
- Depression
- Anxiety
- Suicide
- Paranoia
- Psychosis
If you don’t feel supported or well-connected, studies show you might also have a stronger physical response to stress. This could lead to a higher resting heart rate and unhealthy blood pressure, cholesterol, and inflammation. The effects may not go away if you’re isolated and lonely all the time.
Risk Factors for Social Isolation and Loneliness in Older Adults
Aging often involves loss. You may retire and lose work connections, children might move away, and spouses and friends may die. Also, physical or cognitive impairments can make it hard to communicate or leave the house as often as you’d like.
While many aspects of older adulthood can boost your odds of social isolation and loneliness, your chances may be higher if you:
- Have lower income
- Aren’t married
- Moved here from another country
- Are LGBTQ+
- Are Black, Asian, or belong to another minority group
- Experience elder abuse
Some health conditions that raise your odds of social isolation and loneliness include:
- Depression
- Stroke
- Hearing or vision loss
- Alzheimer’s disease and other dementias
- Chronic obstructive pulmonary disease (COPD)
You may also face social isolation and loneliness if you:
- Are suddenly separated from friends or family
- Become a caregiver for a sick or aging loved one
- Can’t drive or access transportation
- Have a disability that affects how you move or think
How to Spot Signs of Social Isolation or Loneliness in Older Adults
Ask the older people in your life – directly – how they feel about their social connections. Some health professionals use the UCLA 3-Item Loneliness Scale as a screening tool, which includes the following questions:
- How often do you feel that you lack companionship?
- How often do you feel left out?
- How often do you feel isolated from others?
You can also ask things like:
- How many people do you see or talk to each day or week?
- How often do you do things with other people?
- Do you want to be more involved in the community?
- Do mobility issues keep you from going out?
- Do you have trouble seeing or hearing?
- Is language a barrier?
- Have you recently lost a loved one? Would you like to talk to a grief counselor?
Other questions may include:
- How do you feel about the social connections you have?
- How can I help you have more meaningful relationships?
- Would it boost your quality of life if someone came to visit more often?
- Do you feel like you have a sense of purpose?
- What activities did you enjoy in the past that you’d like to revisit?
Other signs of social isolation and loneliness to watch for include:
- Not leaving the house much or at all
- New weight gain or weight loss
- Mood changes, such as depression
- Not doing everyday things like paying bills or cooking
- Forgetting to take medicine or go to the doctor
- A messy or unclean home
- Not keeping up with personal hygiene
- Being less trustful of others
Encourage your loved one to talk to their doctor if you think they’re isolated or lonely. Urge them to bring up any life stressors, physical problems, or hard feelings that may be getting in the way of their social connections.
How to Help Someone Who Is Socially Isolated or Lonely
Loneliness and isolation can be problems at any stage of life, and many older adults lead full social lives without extra support. But here are some tips to help you and your loved one stay connected:
Keep in touch. When possible, meet face-to-face. Older adults tend to benefit more from in-person contact, compared to communication through phone calls, emails, or letters.
Get to know your older neighbors. Social connection can strengthen communities, and friendships across generations can benefit people of all ages. So, if you haven’t already, reach out to the older adults in your neighborhood and check in often.
Find a geriatrician. These are primary care doctors who specialize in the medical care of aging people. They can check for and treat physical and cognitive problems that mainly affect older adults. If needed, they can refer your loved one to other health professionals or resources.
Plan for preventive care. Make sure your loved one keeps up with dental appointments, vaccinations, or other routine checkups. Discuss advance care planning if they don’t have an end-of-life directive or health care proxy (someone legally allowed to make medical decisions for them) in place.
Use adaptive devices. Encourage your loved one to use devices like hearing or vision aids that can help them adjust to life with functional loss. If you’re not sure what kind of tools might help them stay connected, ask a doctor or occupational therapist who works with older adults for tips.
Take advantage of technology. Early research shows that the use of digital devices and social media can boost well-being in older adults and help lessen isolation and feelings of loneliness.
Arrange transportation. While many older adults want to be out in the world just as much as younger folks, they may have problems getting around that make it harder to travel, drive, or walk long distances on their own. Offer to drive or set up rideshare services to get them where they want to go.
Tap into services for older adults. Search online for community programs in your area. If you’re not sure where to get started, type in “programs and services for older adults near me” and see what pops up.
Other resources include:
- Area Agencies on Aging
- Aging and Disability Resource Centers
- Eldercare locator
- National Council on Aging
- National Institute on Aging
- Local extension services
Try the 5-for-5 Connection Challenge. The surgeon general urges people to use this tool to build and strengthen social relationships. People of all ages can take part. Here’s how it works:
- Think of five things to do 5 days in a row to connect with people in your life.
- Each day, pick one action (express gratitude, offer support, volunteer, ask for help).
- Write down how those actions made you feel.
- Share your experience in person or online to urge other people to connect.
Visit SurgeonGeneral.gov/Challenge for more information or to download a toolkit.
Show Sources
Photo Credit: Moment/Getty Images
SOURCES:
Eileen Graham, PhD, associate professor, medical social sciences (determinants of health), Northwestern University Feinberg School of Medicine.
Thomas Cudjoe, MD, MPH, geriatrician; assistant professor of medicine, Johns Hopkins University School of Medicine.
Andrew Cohen, MD, DPhil, assistant professor of internal medicine (geriatrics), Yale School of Medicine.
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